Report of a Case of Adiposis Dolorosa, Showing Imperfect Development of the Ribs and Vertebræ

Abstract

DEMONSTRATOR OF ORTHOPEDIC SURGERY IN THE JEFFERSON MEDICAL COLLEGEM. K., female, age 28 years, white, Hungarian; occupation, candy wrapper; applied at the Orthopedic Dispensary of Jefferson Hospital on May 21, 1908, complaining of pain in the back and hips. The personal and family history will be here omitted as it will be fully presented in the neurological report. At this time, she had on a spinal brace which she had been wearing for about a year and a half. Examination of the patient's back disclosed a marked high dorsal kyphosis with the apex at about the level of the fourth dorsal vertebra; a .left lateral curvature most marked at about the region of the eighth dorsal vertebra. While there was no real ankylosis, the column was markedly rigid, a condition possibly due to the long-continued fixation of the spine by means of the brace. Further inspection of the other bones and joints revealed nothing of note. An X-ray was taken by Dr. Willis F. Manges, of the back including the entire spine and the pelvis, and here we had revealed an explanation of the distortion as noted above. We find the cervical vertebrae large and as well developed as we would expect of a woman of this patient's build. When we come to examine the dorsal vertebrae we find quite a marked difference, not as to the distortion alone, but we find a diminution in size both in the horizontal and vertical contours of the bodies of the vertebrae, and, as far as can be made out, of the processes as well. The ribs, while also reduced in size, have suffered the alterations in diameter only, as they are of about normal length,